Three-Dimensional Multivoxel Proton MR Spectroscopy of the Brain in Children with Neurofibromatosis Type 1
Oded Gonena,
Zhiyue J. Wanga,
A. Kasi Viswanathana,
Patricia T. Molloya and
Robert A. Zimmermana
a From the Division of Medical Science, Fox Chase Cancer Center, Philadelphia, PA (O.G., A.K.V.); and the Department of Radiology, the Children's Hospital of Philadelphia (Z.J.W., P.T.M., R.A.Z.).
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FIG 2. Top, Sagittal image shows the placement of the 6 x 6 x 6-cm PRESS VOI, the four 1.5-cm-thick HSI slices, a–d, and the chiasmal glioma (arrow) in a 3-year-old boy.
a–d, Axial T2-weighted images (FOV = 22 cm) of the corresponding HSI slices, superimposed with the axial projection of the 6 x 6-cm VOIs. The FASI regions were marked with a solid black line by a neuroradiologist. The dotted circle in d indicates the location of the glioma.
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FIG 3. a–d, Real part of the proton spectra from the PRESS boxes on the corresponding images in figure 2. The tumor spectrum in d is highlighted with a dashed shaded circle, and regions of elevated 2>Cho:Cr>1.3 are shaded. All spectra display the 4.0 to 0.5 ppm chemical shift range and are plotted on the same vertical scale, and each represents signal from a 1.5-cm3 voxel
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FIG 4. Top, Sagittal image superimposed with the 6 x 6 x 6-cm PRESS VOI, the four 1.5-cm-thick HSI slices, a–d, and the brain stem glioma in an 11-year-old girl (arrow).
a–d, PRESS VOIs and FASI regions are marked with a solid black line on the corresponding axial T2-weighted images (FOV = 22 cm) from slices a–d. The dotted circles on axial images c and d indicate the location of the glioma.
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FIG 5. a–d, Real part of the proton spectra from the VOIs on the corresponding images in figure 4. The spectra from the tumor in slices c and d in the dashed circle and regions of elevated 2>Cho:Cr>1.3 are shaded. All spectra display the 4.0 to 0.5 ppm chemical shift range and are plotted on the same vertical scale, and each represents the signal from a 1.5-cm3 voxel
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FIG 6. Top row, Axial images show the location of the PRESS boxes and 1 x 1-cm CSI grid from the brain of a healthy male 7-month-old control subject, corresponding to the patient in figures 2c and d and 3c and d.
Bottom row, Real part of the 8 x 8 proton spectra matrices from the corresponding PRESS boxes. Spectra display the 4.0 to 0.5 ppm chemical shift range from each 1-cm3 voxel and are on a common intensity grid.
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FIG 7. Top, Axial images show the location of the PRESS boxes and 1 x 1-cm CSI grid from the brain of a healthy male 11-year-old control subject, corresponding to the patient in figures 4c and d and 5c and d.
Bottom, Real part of the 8 x 8 proton spectra matrices from the corresponding PRESS boxes. Spectra display the 4.0 to 0.5 ppm chemical shift range from each 1-cm3 voxel and are on a common intensity grid.
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